Assessment & Research

The motor repertoire in 3- to 5-month old infants with Down syndrome.

Herrero et al. (2017) · Research in developmental disabilities 2017
★ The Verdict

Expect most 3- to 5-month-old infants with Down syndrome to show atypical fidgety movements—use this quick screen to start motor support early.

✓ Read this if BCBAs who coach families of babies with Down syndrome in home or clinic settings.
✗ Skip if Practitioners working only with verbal school-age or adult clients.

01Research in Context

01

What this study did

Doctors filmed 3- to 5-month-old babies with Down syndrome while they lay on their backs.

They scored each baby’s fidgety arm and leg movements for speed, size, and smoothness.

The team compared these scores to videos of same-age babies without Down syndrome.

02

What they found

Only three in ten babies with Down syndrome showed normal, tiny fidgety motions.

The rest had jerky, too-big, or absent fidgety movements.

Lower movement scores matched lower overall motor quality.

03

How this fits with other research

Marchal et al. (2016) tracked the same children for ten years. They later saw that aiming and catching became a small strength, even though early fidgety scores were poor.

de Campos et al. (2013) also filmed babies with Down syndrome and found they touched and explored toys less often than peers. Together, the two studies show early motor delays start before reaching begins.

Sharp et al. (2010) followed daily-living skills and saw a plateau around age twelve. Early motor flags in the first half-year may signal the start of this slower adaptive path.

04

Why it matters

Spotting weak fidgety movements at four months gives you a clear, early warning. Share the short clip with parents and refer to physical therapy right away. Track toy contact and caregiver play style during home visits, since both link to later movement and self-care. Early action can push back the adaptive plateau seen in school years.

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→ Action — try this Monday

Film a one-minute supine play clip, count tiny fidgety motions, and flag jerky or absent moves for PT referral.

02At a glance

Intervention
not applicable
Design
case series
Sample size
47
Population
down syndrome
Finding
negative
Magnitude
medium

03Original abstract

BACKGROUND: Even though Down syndrome is the most common chromosomal cause of intellectual disability, studies on early development are scarce. AIM: To describe movements and postures in 3- to 5-month-old infants with Down syndrome and assess the relation between pre- and perinatal risk factors and the eventual motor performance. METHODS AND PROCEDURES: Exploratory study; 47 infants with Down syndrome (26 males, 27 infants born preterm, 22 infants with congenital heart disease) were videoed at 10-19 weeks post-term (median=14 weeks). We assessed their Motor Optimality Score (MOS) based on postures and movements (including fidgety movements) and compared it to that of 47 infants later diagnosed with cerebral palsy and 47 infants with a normal neurological outcome, matched for gestational and recording ages. OUTCOMES AND RESULTS: The MOS (median=13, range 10-28) was significantly lower than in infants with a normal neurological outcome (median=26), but higher than in infants later diagnosed with cerebral palsy (median=6). Fourteen infants with Down syndrome showed normal fidgety movements, 13 no fidgety movements, and 20 exaggerated, too fast or too slow fidgety movements. A lack of movements to the midline and several atypical postures were observed. Neither preterm birth nor congenital heart disease was related to aberrant fidgety movements or reduced MOS. CONCLUSIONS AND IMPLICATIONS: The heterogeneity in fidgety movements and MOS add to an understanding of the large variability of the early phenotype of Down syndrome. Studies on the predictive values of the early spontaneous motor repertoire, especially for the cognitive outcome, are warranted. WHAT THIS PAPER ADDS: The significance of this exploratory study lies in its minute description of the motor repertoire of infants with Down syndrome aged 3-5 months. Thirty percent of infants with Down syndrome showed age-specific normal fidgety movements. The rate of abnormal fidgety movements (large amplitude, high/slow speed) or a lack of fidgety movements was exceedingly high. The motor optimality score of infants with Down syndrome was lower than in infants with normal neurological outcome but higher than in infants who were later diagnosed with cerebral palsy. Neither preterm birth nor congenital heart disease were related to the motor performance at 3-5 months.

Research in developmental disabilities, 2017 · doi:10.1016/j.ridd.2017.05.006